This beautifully-written, subtle and supple investigation into the ways in which ‘the vapours’ appear in writings of the long eighteenth century, mainly in France but also in Britain, is completely convincing in the way it argues for, as the title has it, “the invention of a medical category.” Its identification of the status shift of the doctor from “court physician to citizen physician” (228) is also persuasive, and this corpus of material perfect for the demonstration. Further, what I take to be its most important and most urgent thesis, that attention to the “written formats and rhetorical strategies used to present the category” (254) is crucial to have any understanding of the history of science – whether in relation to the category of hysteria or any other, is compellingly argued, and of course must be true, particularly in an era before the fixing of specialist disciplinary discourse. I would want to argue that the history of science should always take into account the forms taken by the discourses of knowledge or ‘science,’ but it is true that this becomes harder in the modern era, because the more specialist and established they are, the more hermetic they become, and the less an external analyst, not already trained within that discipline and therefore to some extent already habituated to thinking according to its established patterns, will be able to comment on it. However, eighteenth-century writing is not hermetic, in this or probably any other area. On the contrary, it is remarkably porous, and in Sabine Arnaud it has found a fine exegete, attentive to epistemic, philosophical, and literary aspects of writing in all their claims, shapes and patterns.
This is partly evidenced in Arnaud’s very choice of material and in her brilliant archival research. Thus, for example, the case (socially important in that it involves contagious vapours amongst the working class and is no longer confined to high-born women) related in The Gentleman’s Magazine of 1787: “one young female worker threw a mouse at the breast of her neighbor, who then experienced convulsions” (35): the convulsions spread amongst the workforce and then leap five miles to another factory. The symptoms are brought to an end by the doctor’s application of electric shocks, and “a glass of wine was served to all, and the eradication of symptoms celebrated with a dance” (35). This in itself – even without further commentary – is a condensed novel and moral tract and medical case study, a social snapshot of extreme bizarreness and particularity, from the grotesque or humorous details (the mouse, the electric shocks, the wine, the dance) to the social structures in which it all unfolds, not excluding the fact that this discussion was published in a magazine for gentlemen. Arnaud doesn’t linger to analyse it, and surely she doesn’t need to: the larger structure of her argument (that vapours moved from being a high-class condition to a more socially-generalised one) requires her to move on, but what’s important is that the account is there, that she makes it available for us, so that we, if we want to, can apply her methodological recommendations, and look at symptoms as defined by their social and written context.
The epistolary consultations she discusses – whereby patients consult their doctor by letter – are particularly fertile ground for this approach. The prominent Swiss physician Théodore Tronchin’s letters to Mme de Belzunce, conserved amongst his papers in the Bibliothèque publique et universitaire de Genève, are quoted at length by Arnaud (120-1; 126-7). For those of us who come to the cultural history of medicine from a literary background, their similarity to ‘actual’ literature is startling, so much so that it is hard to believe that they do not come from a novel. Tronchin’s tone is by turns courteous and amorous (“Each time you do me the grace of writing to me, you repeat that you don’t know if I still remember your existence”), castigatory and condescending (“most of the ailments you have taken the trouble to recount to me, and that, out of compassion, I read from beginning to end, are pseudo-ailments”), and very free with its tragic labels (“I will send you back your sad papers”). To read these letters is to ask oneself whether our identification of what is fiction and what is not is itself at fault, and whether it’s not just the history of science which needs to open its approach to different disciplinary methodologies and assumptions. Perhaps it’s not just that medical writings are saturated with contemporaneous ways of conceptualising the world, some of which relate to the conventions and expectations of literature, but that, conversely, literary writings are exact reproductions of the conventions and expectations of society. Arnaud later brings the great writer Germaine de Staël into her discussion, looking at how the imaginative brilliance of her eponymous heroine Corinne cannot be reduced to a mere diagnosis of the vapours (249), but Tronchin’s letters in particular do seem to cry out to be set alongside Isabelle de Charrière’s searing Letters from Mistress Henley (1784), in which the heroine’s emotional distress – related through her correspondence with a friend – is pathologised by her husband and beyond him by her doctor.
In fact, I’m so convinced that Arnaud is right about the deep structural and conceptual role that writing performs in all parts of knowledge and its communication in the early modern period that I would want to ask her to push backwards chronologically, and look even deeper at the to and fro between ‘literature’ and ‘science’. What would she make, for example, of Robert Burton’s Anatomy of Melancholy (1621) or of Thomas Browne’s Religio Medici (1643): do they shift her identification of Cheyne’s English Malady of 1733 as initiating a completely new sort of text, in which the doctor performs his own failings and maladies? And how do Browne and Burton – or Cheyne – or Rousseau – relate to Montaigne, or even to St Augustine? Of course it would be impossible for one book to deal with all this and maintain any sort of meaningful scholarly rigour, but perhaps it does mean that we should be even more cautious about identifying the beginnings and ends of any particular discourse: if Arnaud is right to displace the discussion of hysteria backwards from the nineteenth to the eighteenth century, then perhaps my query to her would be not whether we should push it back even further, but whether we should ask why it is we identify particular centuries as meaningful, as initiatory, as key? Is it not on the one hand to do with our own academic profession, in which we are expected to be ‘specialist’ in the particular discourse of a particular period, and on the other a residual assumption about progress? And do not both of these aspects influence the results we produce, such that we almost automatically make claims about novelty? Are we right to do so? And is there any other way?
Caroline Warman is Associate Professor in French at the University of Oxford and a Fellow of Jesus College. She is currently completing a book on Diderot’s Eléments de physiologie, and has published widely on eighteenth-century discourses of materialism in all their glorious variety, from Diderot’s dramatic textual experiments to Sade’s startling pornography. She has recently contributed chapters on the Eighteenth Century to the new Cambridge Companion to French Literature, ed. John D. Lyons (CUP, 2016) and on Pre-Romantic French Thought to the Oxford Handbook of European Romanticism, ed. Paul Hamilton (OUP, 2016). She is the translator of Isabelle de Charrière’s Nobleman and Other Romances (Penguin, 2012), co-translator (with Kate E. Tunstall) of essays by Marian Hobson, Diderot and Rousseau: Networks of Enlightenment (VF, 2011) and also Rameau’s Nephew by Diderot (OpenBook, 2014). The recent translation project she led, and to which 102 students and tutors contributed, Tolerance: The Beacon of the Enlightenment (OpenBook, 2016) was downloaded 10,000 times in its first week.